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The short-term outcome of depressive disorder in adolescents attending primary care: a cohort study

Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Background

Depressive disorder is common amongst adolescents attending primary care, but little is known about its time course.

Aim

To determine the 6-month outcome of depressive disorder in adolescent primary care attendees with regard to the time to recovery from (1) the date of index GP consultation and (2) the date of depressive episode onset, and to identify risk factors associated with time to recovery.

Method

A prospective cohort study of 13–18-year-olds attending a general practice in northwest London. Attendees were screened for depressive disorder at consultation: high scorers underwent a psychiatric research interview. Six months later, adolescents who were depressed at consultation were interviewed using a research psychiatric follow-up interview.

Results

Of the 274 young people who completed the baseline questionnaires, 26 had a depressive disorder at consultation; over 50% failed to recover by the 6-month follow-up. Median episode duration from illness onset was 13 months. Multivariate cox regression showed that fewer positive life events and more physical symptoms predicted a longer time to recovery from consultation. Younger age, fewer recent positive life events and more depressive symptoms predicted a longer time to recovery from illness onset.

Conclusions

Adolescent depressive disorders in general practice attendees are persistent, highlighting the appropriateness of intervention.

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Acknowledgments

Dr Julia Gledhill was supported by a research training fellowship from The Wellcome Trust. Financial support was also received from the North Central Thames Primary Care Research Network (NoCTeN) and the West London Mental Health NHS Trust Research and Development Fund. We are grateful to Dr Elena Kulinskaya for statistical advice, Drs Shirley Pat Fong, Chris Wee and Pilar Gamazo as well as Shaheina Kahn and Kulvinder Kaur for assistance with data collection and analysis. We thank all the GPs and staff at the Millway Medical Practice in London and all the young people who participated in the study and their families who supported them in doing so. We are grateful for support from the NIHR Biomedical Research Centre funding scheme.

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Gledhill, J., Garralda, M.E. The short-term outcome of depressive disorder in adolescents attending primary care: a cohort study. Soc Psychiatry Psychiatr Epidemiol 46, 993–1002 (2011). https://doi.org/10.1007/s00127-010-0271-6

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  • DOI: https://doi.org/10.1007/s00127-010-0271-6

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